Healthcare Provider Details

I. General information

NPI: 1518918176
Provider Name (Legal Business Name): ROSS CURTIS AGNOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1063
US

IV. Provider business mailing address

7332 BURNTWOOD WAY
HUDSON OH
44236-1698
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8823
  • Fax: 330-296-6535
Mailing address:
  • Phone: 330-543-8823
  • Fax: 330-296-6535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35-069074
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: